Prevention and treatment efforts in HIV infected or at risk youth require a collaborative effort between clinical research sites with multidisciplinary staff experienced in adolescent medicine, and community organizations such as local health departments, youth service providers, HIV community based organizations and faith based organizations. Such collaboration and a youth friendly environment with creative approaches to successful accrual and retention of youth in clinical studies exist at the St. Jude Memphis Adolescent Trials Unit (ATU). The specific aims of this proposal from a re-competing ATU in Memphis are: 1) To maintain the clinical research infrastructure that supports the Adolescent Medicine Trials Network's (ATN) scientific agenda through the recruitment and retention of HIV-infected and at-risk HIV-uninfected youth into primary, secondary and tertiary prevention studies. 2) To enhance secondary prevention efforts by improving linkage to care of patients newly diagnosed with HIV. 3) To expand and optimize new and existing community linkages that maintain a community-based primary prevention infrastructure that will support HIV preventive biomedical clinical trials, including vaccines, microbicides, pre-exposure prophylaxis and integrated biomedical and behavioral trials. 4) To contribute to the scientific agenda of the Adolescent Medicine Trials Network through the participation of investigators and site personnel in the development of protocols. Memphis, located in the county with the highest sexually transmitted disease rates in Tennessee and with a predominantly black population has been particularly affected by the HIV epidemic. Since its inception in 1987, the St. Jude HIV program has actively participated in clinical research. With 319 enrollments in ATN protocols since joining the network in 2006, the St. Jude Memphis ATU has earned its place as a top performing ATU and looks forward to furthering the ATN scientific agenda in the coming years. Increasing HIV testing amongst youth, improving linkage to care through outreach, and continuing to provide comprehensive care and resources to support engagement and retention in clinical care and research protocols are some of the major components of the St. Jude Memphis ATU's proposed plan. RELEVANCE: In the United States, HIV infection rates are increasing most rapidly among youth, in blacks, and in the South. An intervention program in Memphis, with its location in the South, a predominantly black population, and high STD rates, is poised to have a significant impact on this epidemic. The outstanding comprehensive HIV care and clinical research experience at St. Jude ensure a high-performing program.